Tuesday, December 27, 2011

This post is in honor of the two best doctors in America, and possibly the world.

While their names aren't known to the general public, they're instantly recognizable to all of us in the medical profession. And, in spite of their amazing talents, neither has ever been recognized by any of the various "Best Doc" magazines published in different cities.

So I feel that, after years of them laboring in secret, it's time to honor them.

AND THE 2 BEST DOCTORS ON THE PLANET ARE:

Some Guy, M.D. and This Lady, M.D.

And here is why they so richly deserve this honor:

1. Accessibility.

I don't know either of them personally. In fact, they have no phone listing. Yet, they're far more accessible than any other doctor I know. While I only see people in my office, or the hospital, during certain hours, Drs. Guy and Lady are accessible anywhere, anytime. Patients tell me they run into them at grocery stores, beauty salons, amusement parks, laundromats, hardware stores, cocktail parties- anywhere.

I might get a little irritated (okay, a lot irritated) if patients were to corner me for a consultation while I was out with my family, but not Some Guy or This Lady! In fact, from what I've been told, they don't mind at all, and often initiate the discussions themselves!

2. Cost.

This is how I make a living. I like this job, but it's still my job. I have a family to support. So Mary has to make sure we take your insurance, collect your co-pay, etc.

But not Drs. Guy and Lady! They don't check those minor details before providing treatment! As best I can tell, they don't charge anything for their time and advice.

3. Sheer brilliance.

I, and most doctors, do physical exams and order tests. They may vary from a few labs to an MRI, but generally that's how we get an idea of what's going on, and what the best course of action will be. Not Some Guy or This Lady, though!

They appear to have an uncanny knowledge of EXACTLY what's going on with you, even though they never touch you, ask detailed questions, or order any studies whatsoever! I can only assume they must always be right, as my brief search of American medical board records showed that neither of them has ever been subject to a single complaint or lawsuit!

4. Treatments

I prescribe medications. Some are cheap, some hideously expensive. But I do it to help you.

But Drs. Guy and Lady apparently have knowledge of treatments beyond the medical realm, which they generously share free of charge, involving a number of simple over-the-counter remedies that can apparently cure anything.

5. Knowledge.

I'm a specialist. I know a lot about common things in my fields, less about rarer disorders, and only a little bit about other fields. I think most other specialists would say the same.

But this amazing pair knows about EVERYTHING. They are general practitioners extraordinaire, with a knowledge fund that puts even the greatest doctors, like Osler, Charcot, or (my personal idol) Oscar London, to shame.

I can only assume this tremendous knowledge has come from experience. Some diseases are so rare that many of us go through an entire career without seeing them, but these two have seen ALL OF IT! They have incredible connections that have led to this (usually involving their uncle's friend's second cousin's wife, who once met a lady who's sister might have had the rare disorder).

6. Trust.

There's this mysterious thing called the Doctor-Patient relationship. It involves trust, and can take a while to build. There's some chemistry in it, and conversation, and voodoo. But it's critical to helping people.

But while it can take 1 or more appointments for most doctors and patients to reach this stage, for these two it's amazingly instantaneous. Most patients who get advice from them trust them automatically and completely, and are quite confident in their diagnostic and treatment abilities. This is in spite of (or perhaps because) they don't appear to have the same, years-long, formal medical training that I and my colleagues do.

7. International reputation.

I only practice in Grumpyville, and only have one medical license. But these 2 apparently are somehow EVERWHERE. I've had patients run into them in all 50 states, and even on overseas trips. Quite frankly, hearing about them makes me embarrassed to only be able to cover 1 hospital.

So, as 2011 comes to a close, I salute these 2 giants of medicine, and their numerous contributions to patient care.

I'm too old fashioned, I guess. I couldn't imagine asking my physician a question while not at an appointment. I used to see my former physician at the local grocery store and always made a point of saying hello, how are you, but that was it. At the holidays I would stop by his office with a carton of Clementines as a thank you.

My attitude is that if I develop a medical condition, I'm going to pay for an appointment, and trust that the doctor knows what he/she is doing, not ask a friend/co-worker. I don't even go to the medical web sites because I don't know how honest they are.

I don't know either Some Guy, MD or This Lady, MD. I DO know my actual physician, and specialist when I need one.

Your number 6 is very important to me. The doctors that I have dealt with in this new area actually LISTEN, and have been very helpful.

The bottom line is: my doctors don't tell me how to design spacecraft, and I don't tell them how to practice medicine. I think this works for all of us.

Well I guess Dr Grumpy would be that good if he chose to practice Alternative 'Medicine' as well. He'd learn all the mystical wisdom of the cosmos, gain an emotional connection to the universe, and wouldn't have to charge for his magic because he'd have a sideline in changing the formation of atoms do they became gold (and in turn, slowly destroy the gold market by excessive supplies).

Western Medicine is so Western. That stuff from far away must be better because it is found far away, in the lands where wizards and dragons still live.

In my veterinary practice it's the amazing Dr. Google who blows my mind with his/her prescient diagnoses, unfailing treatments, and horrific grammar and spelling. Drs. Guy and Lady, bless their hearts, have taken a backseat to Dr. Google. I think this is because Guy and Lady, et al make the mistake of seeing clients at brick-and-mortar establishments like pet stores, which are being rapidly eclipsed by the internet doggie shops. As are we all.

But, @dvmfly, to me the most remarkable thing about this pair of geniuses, which Ibee forgot to mention, is that they are in addition to being physicians, also practicing veterinarians. I mean, I hear about their feats of wonder all the time - don't you?

I think you also need to add Dr They to the list. "They" say this, "They" said that. " they "recommend that... that's what I hear every day. Someone will ask me what I recommend and when I do I am always debunked by the comment " Oh? what about this ( grabbing something else) THEY say this is good..." I wanna meet THEY. and punch him right in the mouth.

I've heard of both of them as well as the previous comment mentioning Dr. Google. I think they moonlight as pharmacists too because people come in all the time telling us how "some pharmacist guy/lady" told us what we told them was wrong and what they really needed to take instead of their prescribed drugs.

You know, this really brings into focus why my doctors goggle when I give them a complete and honest rundown of whatever I am experiencing and - gasp - trust their diagnosis and - FAINT - follow the prescribed treatment. If I have an issue with a prescribed treatment I - sit down now - discuss the issue I have to see if their is an effective alternative or if I have to bite the bullet and do what I don't wanna do (unreasonable hatred of nasal sprays, I'm looking at you!)

I never could understand people who don't trust their doctors ... why are they your doctor if you don't trust them?

Dr. Grumpy, you do not need to post this, but I DO page Dr. Google all the time and here's why. I page this fine doc at reputable sites such as the NIH, Mayo, Slone Kettering, Johns Hopkins, Ohio State and many others. I had nearly died from Grave's disease and yes, diagnosed myself at a difficult to use site called Wrong Diagnosis.com. Ended up with no insuracne for a time, ugly but was not diagnosed when I had said insurance. TSH of .0009, yeah that IS accurate, three zeros and was sick and tachycardic. Guess what? I also had MS at the same time and that only took several years to be figured out. It was my co-worker who told me that I had it (becasue she has it and knows all the symptoms) and it was later confirmed by a super nice neuro at local large teaching hospital. Even had a nice ER visit follwing an eye surgery and STILL the MS wasn't figured out until I had to ASK to see a neuro. Then I got booted to an MS subspecialist who thought it was neuromyelitis optica (which yes, can kill within 2 to 5 similarly to an ALS kind of thing) vs. primary progressive MS and said he would do NOTHING for me at all, NOTHING. OK, so PP has no FDA approved treatment, but I am classified as a transitional person as I have had ONE big time attack and so have MANY Primary Progressive patients, even though we may not have a totally typical presentation. Many neuros thus DO put their primary progressive patients on disease modifying drugs and yes, mine have helped a ton in terms of symptom management. even if not really slowing down the degenerative process. I work in health care and our system is BROKEN, broken, broken. People are booted from the hospital (including intensive care) and then end up back in the ER that same day and are readmitted. So it drives docs crazy that we have to page Dr. Google. I live where there is excellent medical care (for those fortunate enough to be insured) and still have not found many docs who are decent diagnosticians. A resident told me that I DID NOT have thyroid eye disease, when I DID and I already knew that I did. Can you hear my frustration? Three diseases and not ONE of them was diagnosed until I had to ask and plead to see specialists and had already figured it out for myself. AAAAAACCCCK. Do not blame patients who read continuously. I am far from the only person who feels that in todays health care system, we have to tell the doctor what is wrong with us and all without benefit of medical school. I get about eight minutes TOPS with my PCP. MANY people on my International MS forum are extremely grateful that they do not live under the United States health care system. Try being on the patient side of the fence, it isn't easy there either. I could write a book. wi

Uh, oh! I hope to goodness they didn't give sumdood an uptown name and let him practice medicine (clutching pearls)!

Yes, I would have thought Dr. Google would have gotten at least an honorable mention.

He always shows up at the Hotel, in conversations like, "Well I read on Google that I really don't need to restrict my fluids at night" or "Why should I take stool softeners if I'm a quadriplegic? I didn't see that on Google?"

(Or maybe Dr. Medical Ad...thought of that with the word verification=spreba...made me think of Spiriva, the wonder inhaler)

While I do approve of doctor google for difficult to diagnose things (after going to multiple doctors and having them say "I don't know, good luck")...

There is a woman I work with who is always trying to be "this lady MD" and telling me why I'm having my problems. Example: Evidently I have lower back pain because my pants waistband is too tight and I should start wearing pants with an elastic waistband... I have learned to not bring up anything close to a medical problem with her.

As a Paramedic I can really appreciate your comments about the doctor patient relationship. I am constantly asked by patients, friends, and acquaintances, "I went to the doctor the other day and he/she said I have X. What's the best way to treat that?" or "The doctor prescribed fukitol for me. What is that for?" My answer is always the same, "Did you ask the doctor?" "No, he/she's really busy, I didn't want to bother them", they say. PEOPLE...... Do you not realize that is the reason you are visiting the doctor? You are paying for their expertise and time. Ask them questions and take their advice. If what they are telling you doesn't sound right then get a second opinion. Don't go back home and ask your neighbor, the retired plumber, for advice and then take the little pink pill that he gives you, that his doctor prescribed for his lumbago. Yeah, that'll really help your blood pressure.

Neuro prof on rounds in a private ward with a patient rehabilitating from a stroke. Obligatory irritating relative. "I read on the in-flight magazine about *magneto-therapy* for stroke in Japan; apparently they are doing great work, blah...blah...blah..."Prof politely says he has never heard of it, tries to examine patient. The dude takes out a notepad and reads *relevant parts of the article* from it! After about 2 or 3 minutes of this crap, prof calls out to the nurse, "Give me the chart please!"

Oh, you forget to mention that these wonderful doctors have NO PROBLEM with callin in Rx's for antibiotics or Percocet at two am on a Sunday to save you that boring and expensive trip to the ED for any and all self-diagnosed illnesses and injuries.

This is consistent with their philosophy of HELPING patients with nice things, like drugs and surgery and bed-rest and diagnoses of disbablity. They never EVER tell THeir precious patients to lose 50 lbs, exercise, stop smoking, cut down on alcohol, or tolerate PT and mean treatments like that!

They must be related to the ubiquitous Two Dudes that have been randomly attacking and beating up all the fine, upstanding, non-swearing, teetotalling, bible-reading victims I used to see in Triage all the time. The vics were always minding their own business on the way to take their grandmas to church (at 3 am, that's how dedicated they were) when those damn Two Dudes showed up at the bus stop (that happened to be outside a bar) where they were waiting and beat the crap out of them for no reason whatsoever.

I completely understand your frustration. Until I was sidelined by rheumatoid arthritis, I was a concert violinist. When I stopped concertizing, I began teaching and was constantly frustrated by how much the students and their parents trusted information more from friends, the internet(AAKK!),school music teachers who were not violinists,etc, etc. They really had no clue of my level of achievement, knowledge, talent, training and skill. Luckily, our interactions did not affect their health!I greatly respect most physicians. I do believe as long as I research in reliable sources like medical journals, etc. that being well informed makes me a better patient. But, I am very careful to form a trusting, respectful relationship with a physician. I wouldn't dream of showing up in a new doctor's office with a pile of printouts from the internet! (Especially if it is a pile of CRAP!!) Before I have had several occasions where doing my own research has made all the difference in my care. The first instance was the diagnosis of my rheumatoid arthritis. I had been having progressively worse symptoms for 3 years and despite reporting them to my primary care doctor over many visits, had not gotten diagnosed. After doing my own research, I asked him for an ANA and rheumatoid factor test. I never heard back about the tests, and when I finally talked to him about it he told me that they were negative. I asked the office to send me a copy for my records and was shocked to find that the Rh factor and ANA (speckled??)was POSITIVE. When I asked the doctor why he didn't tell me he said it was because my ESR was not elevated and he believed that indicated the other tests were false positives (???). I demanded a referral to a rheumatologist who diagnosed me with a severe case of RA.By the American College of Rheumatology Classification for diagnoses which you need to have at least 4 or the 7 criteria, I had all 7 criteria. He was shocked my PCP missed my diagnoses for so long. He also withdrew an enormous syringe full of liquid from one of my knees. The other instance was when I had a problem with my feet which were badly deformed from the RA. My podiatrist told me I had to immediately amputate one of my toes due to a bone infection, and that there was no point in trying to reconstruct my feet because the bone was too "mushy"(?). My feet were so bad at the time that I was about to order a scooter (at age 45!). I did some research and found a surgeon at Mayo. They were able to do a special radioactive test that tagged my white blood cells and proved that I did not have a bone infection and did not need to have my toe amputated. He performed a rheumatoid forefoot reconstruction on both feet which has changed my life and has allowed me to dramatically decrease my pain meds.Dr.Grumpy, you may be grumpy but I can tell you really care about your patients. Don’t let the patient's who are too stupid to respect your knowledge and training keep you from being open forming a partnership with patients who are respectful and want to take part in their own care. And when a patient start quoting Dr.Some Guy or Dr.Google, I think your best bet is to use GIFT FOR HUMOR! Good Luck!

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This blog is entirely for entertainment purposes. All posts about patients may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate.

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